Manns Braden J, Johnson Jeffrey A, Taub Ken, Mortis Garth, Ghali William A, Donaldson Cam
Department of Medicine, University of Calgary, Alberta, Canada.
ASAIO J. 2002 Sep-Oct;48(5):565-9. doi: 10.1097/00002480-200209000-00021.
Patients with end-stage renal disease have significant impairments in health related quality of life (HRQOL). The determinants of HRQOL, including the effect of dialysis adequacy, have not been well studied. This study was designed to investigate whether dialysis adequacy is associated with HRQOL in hemodialysis patients. A cross-sectional survey of 128 patients who had been on hemodialysis for more than 6 months was conducted. Baseline information on demographic factors and detailed clinical information was collected. Average Kt/V levels (for the 3 months preceding HRQOL assessment) were determined. HRQOL was assessed with the Kidney Disease Quality of Life Short Form, the Short Form-36 (SF-36), and the EuroQol EQ-5D. Multiple linear regression was performed to control for differences in important baseline covariates. Patients with average Kt/V levels greater than or equal to 1.3 had better HRQOL as measured by significantly higher scores (p < 0.05) in 4 of 11 kidney disease targeted domains, 6 of 8 SF-36 domains, and on the EQ-5D visual analog scale and index score. Using multiple linear regression to control for important covariates, the adjusted EQ-5D index score was higher by 0.036 (95% confidence intervals 0.015, 0.057) for each 0.1 increment in Kt/V, which is both statistically and clinically significant. Dialysis adequacy was significantly associated with HRQOL in hemodialysis patients. Controlled studies that examine the effect of increasing Kt/V on HRQOL are needed.
终末期肾病患者的健康相关生活质量（HRQOL）存在显著损害。HRQOL的决定因素，包括透析充分性的影响，尚未得到充分研究。本研究旨在调查透析充分性是否与血液透析患者的HRQOL相关。对128例接受血液透析超过6个月的患者进行了横断面调查。收集了人口统计学因素的基线信息和详细的临床信息。测定了平均Kt/V水平（在HRQOL评估前3个月）。使用肾脏疾病生活质量简表、简明健康状况调查量表（SF-36）和欧洲五维健康量表（EuroQol EQ-5D）对HRQOL进行评估。进行多元线性回归以控制重要基线协变量的差异。平均Kt/V水平大于或等于1.3的患者，在11个肾脏疾病靶向领域中的4个、SF-36的8个领域中的6个以及EQ-5D视觉模拟量表和指数评分方面，得分显著更高（p<0.0），表明HRQOL更好。使用多元线性回归控制重要协变量后，Kt/V每增加0.1，调整后的EQ-5D指数评分就会提高0.036（95%置信区间0.015，0.057），这在统计学和临床上均具有显著意义。透析充分性与血液透析患者的HRQOL显著相关。需要进行对照研究来考察提高Kt/V对HRQOL的影响。
